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Toni.

IIH professional taught Aubreiauna Behavior and Anger Management Skills in order to Help them develop and implement anger management techniques, and improve Communication skills to decrease angry outburst and increase positive interaction among their family and peers by: -Taught skill alternatives to aggression by using self control 1) Tune into what is going on in your body that helps you know that you are about to lose control of yourself (are you getting tense, angry, hot, fidgety-pay attention to internal cues; 2) Decide what happened to make you feel that way (consider outside events or internal events (thoughts)-did someone say or do something to make you mad/upset or did a past event trigger you to become mad/upset; 3) Think about ways in which you might control yourself (slow down; count to 10; assert yourself; leave; do something else-think of an activity that will help you calm down before you lose control; 4) Choose the best way to control yourself and do it- engage yourself in the activity. IIH Professional prompted Aubreiauna to practice the skill by role playing scenarios what might cause them to become angry or upset such as 1) being criticized harshly by the teacher you might yell at Him/her or become disrespectful, instead walk away or remain silent and tell a parent or another teacher how you feel about what took place; 2) being yelled at by your aunt to clean your room or another room in the house when were not the one to mess it up, instead of reacting disrespectfully or becoming aggressive with her retreat to your room to clean it or engage in an activity such as your favorite game or pastime and when you both calm down talk to her about how you feel when she yells at you; 3) your friend takes something without asking permission, instead of acting on your anger and fighting your friend, you restrain yourself from becoming aggressive and when youre calm you discuss the incident and your feelings regarding your friend betraying you. -Taught skill alternatives to aggression by negotiating 1) Decide if you and the other person are having a difference of opinion-are you getting tense, or arguing with the other person; 2) Tell the other person what you think about the problem-state your position and your perception of the their position; 3) Ask the them person what he/she thinks about the problem-allow them to state their position and their perception of your position; 4) Listen openly to her/her answer-do not interrupt

them while they are stating their position and wait till they are finished to respond if necessary; 5) Think about why the person might feel ther way-are they feeling that way because of something internal or did you do something to make them feel that way; 6) Suggest a compromisemake sure the proposed compromise takes into account the opinions and feelings of both persons, and vice versa if the other person suggests a compromise. IIH professional had Aubreiauna research the words negotiate and compromise and had them write about past times when he felt he negotiated with someone to come to a solution or compromise on a situation in order to remedy a problem. -----------------------------------------------------------------------------------------------------------------------------------IIH professional taught Joshua Coping and Self Management Skills in order to help him and her family improve coping skills to deal with life circumstances by: -Teaching skills for dealing with stress as it relates to dealing with an accusation 1) Think about what the other person has accused you of. (Is the accusation accurate or inaccurate?) Was it said in a mean way or a constructive way; 2) Think about why the person might have accused you. (Have you infringed on her/them rights or property? Has a rumor been stated by someone else; 3) Think about ways to answer the persons accusation (Deny it; explain your own behavior; correct the other persons perceptions, assert yourself; apologize; offer to make up for what happened). 4) Choose the best way and do it. IIH professional modeled skills for dealing with stress in order to show Joshua how to implement skills for dealing with an accusation 1) A neighbor accuses you of breaking a neighbors window; IIH Professional modeled how to go to the neighbor and explain what happened without anger or aggression. 2) Your aunt accuses you of making a mess in the kitchen; IIH Professional modeled how to correct your aunts perception by letting her know that you did not make a mess on purpose and you will clean it up without yelling at her or becoming disrespectful. 3) A friend accuses you of lying; IIH Professional modeled how to approach your friend deny the accusation without fighting or responding to an accusation with an accusation. ----------------------------------------------------------------------------------------------------------------------------------------Toni. IIH professional taught Toni skills for expressing your feelings by: -IIH Professional taught Toni how to understand the feelings of others by providing her with the steps to effectively learn ther skill such as 1) Watch the other person by noticing the person's tone of voice, posture and facial expression which can be an indication of the person's demeanor; 2) Listen to what the person is saying by understanding the content such as listening out for key words or phrases that may indicate how the person is feeling; 3) Figure out what the them person might be feeling such as the them person might be angry, sad, anxious, disappointed, or irritated; 4) Think about ways to show you understand what the person might be feeling by telling them you understand, providing a gentle affectionate touch such as a hug, or leave the person alone to deal with their feelings, giving them time and

space to calm down and assess their own feelings; 5) Decide on the best way and do it, be confident and okay with your decision. IIH Professional had Toni review the steps previously written down in her journal in order to refer back to the steps when needed and IIH Professional had Toni discuss the understanding that he had for each step again. IIH Professional had Toni review the meaning of the word empathy and find the related words such as compassion, consideration, etc. ----------------------------------------------------------------------------------------------------------------------------------------Toni IIH Professional taught Joshua coping and self management skills by dealing with the feelings of others: -Taught Joshua to 1) Watch the other person; notice tone of voice, posture, and facial expression in order to determine their demeanor. IIH Professional prompted Joshua to model the tone of voice, posture, and facial expression of someone that he feels is angry. 2) Listen to what the other person is saying; read between the lines to determine what the other person is saying; try to understand the content. 3) Figure out what the other person might be feeling; he/she may be angry, sad, anxious, etc. Determine their feelings so that you will know how to respond. 4) Think about ways to show you understand what he/she is feeling. Refer back to the words compassion and empathy; you might express your understanding by telling him/other, touch him/other, or leave the person alone. 5) Decide on the best way and do it. IIH Professional had Joshua brainstorm ways that he could express her compassion and empathy in response to different emotions; sadness, anger, and anxiousness. IIH Professional taught Joshua Coping and Anger Management skills in order to teach him how to deal with her feelings by providing a skill training in regards to Dealing with Someone Elses Anger.

IIH Professional taught Joshua the steps for Dealing with Someone Elses Anger: 1) Listen to the person who is angry without interrupting; remain calm. IIH Professional modeled for Joshua how to remain calm while someone is expressing their anger such as a) begin taking deep breaths; b) count to 10 forwards and backwards; c) leave the room and find something positive to do. 2) Try to understand what the angry person is saying and feeling by asking questions to get explanations of what you dont understand; restate them to yourself. IIH Professional modeled the tone of voice that Joshua should use when responding to the angry person (soft, non-threatening, calm and when he gets a response repeat it to himself silently if he does not understand the reason behind the anger. 3) Decide if you can say or do something to deal with the situation. Think about ways of dealing with the problem. Ther may include just listening, being empathetic, doing something to correct the problem, ignoring it, or being assertive. IIH prompted Joshua to reflect on how he could be show empathy towards her mother or aunt when she is upset instead of meeting them anger with anger and aggression

(think about the good things that she does for you, dont you want them to experience good things as well from them family. ----------------------------------------------------------------------------------------------------------------------------------------IIH Professional taught Brandon advanced social skills in order to teach him how to show remorse when he acts aggressively towards others and causes them injury or possible injury by giving him a number of steps to refer to such as 1) Decide if it would be best for you to apologize for something you did. You might apologize for breaking something, making an error, or interrupting someone. IIH Professional had Brandon write a list of all the things that he has done in the past week that he feels he should apologized for. 2) Think of the different ways you could apologize. Say something or do something. IIH Professional helped Brandon brainstorm the ways he could apologize to the people that he may have hurt or offended for offenses on her list (buy your mother some flowers and verbally apologize for pushing her, draw your sister a card for breaking one of them favorite toys, etc. 3) Choose the best time and place to apologize. Do it privately and as quickly as possible after creating the problem. IIH Professional and Brandon discussed how he should have handled the situation with her mother differently and why he should have apologized immediately in that instance (to show remorse, to set a better example for her little sister). 4) Make your apology. Ther might include an offer to make up for what happened. IIH Professional had Brandon write a letter to her mother including a way that he will make it up to her for her disrespectful, inappropriate, and aggressive behavior. ----------------------------------------------------------------------------------------------------------------------------------------Toni. QP taught Hamza coping and self management skills in or to teach him how to deal with group pressure by providing him with a series of steps that will give him the skills needed to deal with the stress of peer pressure to do the wrong thing such as 1) think about what the group wants you to do and why. Listen to them people; decide what the real meaning is; try to understand what is being said. 2) Decide what you want to do. Yield; resist; delay; negotiate. Choose how you want to respond to what is being asked of you. Try to distract the group from the action and getting you to participate. 3) Decide how to tell the group what you want to do. Give reasons; talk to one person only; delay; assert yourself. Take a stand and choose to do the right thing despite the groups insistence through teasing or threats. 4) Tell the group what you have decided. Make a choice to not participate and stick to your choice. QP role played group pressure scenarios with Hamza to ensure that he understood the skill building exercise (group wants Hamza to steal candy bar, group pressuring Hamza to deface school property) IIH Professional taught Brandon and her sister coping and self management skills to help them deal with life's circumstances. IIH Professional introduced Brandon and her Sister to website: Coping Skills for Kids/Brain Works Project to introduce them to a tool that would benefit them in ther regard without the presence or prompting of Professional support.

IIH Professional taught them how to navigate the website and interact with suggested student involvement activities to support and reinforce concepts, terminology and thinking processes learning about coping skills.

IIH Professional taught Brandon and her sister about how the brain plays a big part in our emotions through an activity called "Ways Our Brain Confuses and Fools US". IIH Professional had Brandon and her sister list and discuss some important facts in regard to the ways that the Brain can confuse adolescents such as: 1)The same part of our brain senses when we have physical or emotional pain; 2)An emotional wound-hurt thats inside us and invisible may cause us to hide or attack; 3)Adolescence is a time when we have lots of emotional brain changes that lead to having mixed feelings such as both loving and hating our parents; or being undecided if you like and dislike another person; 4)Ambivalence causes brain confusion because we don't know which of the two different feelings we have is "true." Actually both are. 5)Our brain has a tough time deciding what to do when we have opposite feelings about the same person or thing; 6)Ther uncertainty actually adds to our stress, particularly during adolescence when our emotional brain is becoming more sensitive.

IIH Professional taught Brandon and her sister one example of how the brain becomes confused by providing exercises that featured Optical Illusions such as 1) a moving face, Electric Motor Optical Illusion, and a Anomalous Motion Optical Illusion.

IIH Professional prompted Brandon and her sister to reflect on times when they have experienced what they might call brain confusion such as when they were angry at someone they really loved or liked but at that time may have done something bad to that person or wished something bad may have happened to them because they were angry. ----------------------------------------------------------------------------------------------------------------------------------------IIH Professional taught Brandon and her sister coping and self management skills to help them deal with life's circumstances.

IIH Professional revisited the website: Coping Skills for Kids/Brain Works Project to teach Brandon and her sister about the Coping Brain it's three major parts 1) Thinking (neocortex); 2) Emotional (mammalian); and 3) Reptilian (survival) and their Functions because they include sensitivity when experiencing emotional pain and helping us get over ther type of pain.

IIH Professional taught Brandon and her sister the definition of "coping brain" (every time we are challenged by new or upsetting experiences our brain must come up with ways to deal with our stress and worry). IIH Professional elaborated on why the "coping brain" activates when we are under emotional stress 1) our brain sometimes needs to find better ways to deal with our upset b/c old ways don't work anymore; 2) we need all three coping brain functions, thinking, feeling, and self protection to get over experiences that make us stressed, worried, angry or upset; 3) training our brain to use healthy coping methods means we can heal our own emotional wounds so we feel better about ourselves. IIH Professional taught Brandon and her sister the 4 core wounding experiences that can arise from emotional distress: 1) loss, 2) rejection, 3) betrayal, 4) humiliation and the 2 choices that we have when experiencing these 4 wounding experiences: 1) hide or ignore; 2)use our coping brain functions to deal with them.

IIH Professional prompted Brandon and her sister to journal about the times when they have experienced the 4 types of wounding experiences.

IIH Professional prepared to elaborate on the 4 types of wounding experiences in the next session in order to continue teaching Brandon and her sister coping skills, why we need to implement them, and why they are a healthy alternative to succumbing to stress and anger. --------------------------------------------------------------------------------------------------------------------------------------IIH Professional taught Brandon and her sister coping and self management skills to help them deal with life's circumstances.

IIH Professional taught Brandon and her sister coping and self management skills to help them deal with life's circumstances.

IIH Professional revisited the website: Coping Skills for Kids/Brain Works Project to teach Brandon and her sister about "Pain in My Brain:4 Core Wounding Experiences".

IIH revisited the 4 Core Wounding Experiences in order to provide a clear understanding of each on the normal feelings that accompany each one such as 1)Loss-Loss creates such a powerful, instinctive brain danger signal it is the most common fear that reptilian and emotional coping brains are sensitized to detect. Throughout adolescence and adult life, a common source of hurt feelings is loss of people in our life who have been important to us; 2)Rejection-our emotional coping brain is the seat of our ability to sense social attachments and a sense of belonging with others. The emotional brain senses when someone we want to be friends with ignores or rejects us for some reason. Ther is one of the most common, everyday reasons for becoming upset and stressed, particularly as we enter adolescence; 3) Betrayal-emotional brain senses our connections with others, humans are not only sensitive to rejection, but also to betrayal by others we trust. Betrayal breaks the bond we have had with someone we have trusted and depended upon. Betrayal has many other forms including the painful experience when someone who has been your friend turns against you by saying or doing something that hurts your feelings; 4)Humiliation-a deep human wound we must learn to cope with because it strikes at the heart of our self respect -- our sense of self [def: ability to think about who we are as a person]. And that sense -- you guessed it occurs in the neocortex, our thinking brain. Maybe thats why we feel so devastated feeling overpowered and unable to get over something very painful and embarrassed being in stress and ashamed of our self.One theory is that humiliation is not only a threat to our thinking brain's sense of self respect, but also activates emotional and reptilian survival responses of violence.

IIH Professional, Brandon and her sister role played scenarios that were related to the 4 core Wounding Experiences and the positive and negative ways to respond to each one. ----------------------------------------------------------------------------------------------------------------------------------------.IIH Professional introduced the website to Brandon's parents and discussed the tools on the website that would assist with teaching Brandon and her sister how to be aware of their feelings, the source, and positive and negative reactions (behaviors) such as the Parents and Educators and Activities sections.

IIH Professional taught Brandon and her sister coping and self management skills to help them deal with life's circumstances.

IIH Professional revisited the website: Coping Skills for Kids/Brain Works Project to teach Brandon and her sister about the common coping myths and mistakes that Adolescents may make so that they can understand whereas their negative behavior is inappropriate it is however a natural response: 1) "I don't care" coping solution-

-most common mistake -may lose our ability to care(lead to many more problems) -can lose the ability to care in a positive way (sympathize with others in pain) -we may become insensitive to hurting other people with our words and actions (having few close friends; lonely) 2) Not realizing the reptilian (survival) brain automatically taking over when we're stressed and hurting-oldest and strongest coping response -when we can't deal with stress or upsets using our thinking brain, we may be ruled by anger and controlled by survival impulses. -have to learn how to use or thinking brain to get over emotional upsets. 3)Instinctive brain coping can become an easy habit. -may get sad or mad out of habit -if we always react to stress by allowing our instinctive brain to automatically deal w/a problem we never learn thinking skills or express our feelings by using words. -habits can be changed by making thoughtful choices. IIH Professional administered an Introduction Exercise for "Name That Upset Game" and had Brandon and her sister complete the exercise individually and went over answers and results.

IIH Professionals taught Brandon and her sister how to play "Name That Upset Game" in which Brandon and her sister selected from a series of upset cards in order to determine which of the four core wounding experiences loss, rejection, betrayal and humiliation the upset might fall under. IIH Professional taught Brandon's Mother skills for managing power struggles with Teens in order to improve communication skills to decrease angry outburst and increase positive interaction among family members.

IIH Professional taught Brandon's mother 6 suggestions for coping with power struggles such as 1) Being Consistent-do what you say you will, and enforce their rules each and every time, will have less issues with power struggles than those who don't; 2) Stay Calm-remain calm and help a child that is being disrespectful or testing limits stay calm or regain calm (use self-talk, count to ten, take deep breaths, leave the situation.); 3) Offering reasonable choices-giving kids limited choices can help them feel a sense of control and often more importantly save face for teens who may find it unpleasant to complete a chore; 4)Staying Respectful-as the adult you should take the high road, don't meet disrespect with more

disrespect, address issue at hand and attitude later; 5) Keeping Consequences Proportionate-wildly irrational consequences are meaningless b/c they won't stick, keep consequences proportionate to what has happened; 6) Keep Consequences Enforceable-most consequences rely on teens cooperation such as extra chores, more homework to enforce. Implement consequences that you have complete control over such as allowance, privileges.

IIH Professional had Brandon's mother make a list of suggestions for coping with power struggles to help her process each point and have materials to review later.

IIH Professional and Brandon's mother role played scenarios that allowed her to practice implementing these suggestions when dealing with everyday encounters with her children.

IIH Professional demonstrated better ways to execute suggestions when Brandon's mother's body language or attitude could have been perceived negatively by her children.

IIH Professional and Brandon's mother discussed the possibility of suggestions not working in her favor because Brandon's mother felt she could learn to do implement techniques but the children have to want to change.

IIH Professional counseled Brandon's mother on making sure she did her best as a parent and on how she provides behavioral examples and how children model a parent's behavior; positive or negative. Toni. IIH QP taught Toni Coping and Self Management Skills in order to improve coping skills to deal with life circumstances. IIH QP taught Toni techniques for effective emotional management by helping her to develop skills in communication, problem solving and relaxation. IIH QP had Toni process the following steps by writing them down to help retain information and so she could refer back to the following skills during times of extreme stress: 1)Talking It Out-use tools to express yourself appropriately through the use of "I Messages", identifying feelings, scaling to be able to discuss the intensity of your feelings. IIH Professional had Toni identify several people that she feels comfortable discussing problems with so that she can be able to validate her feelings with attention and time from a valued adult; 2)Brainstorming-IIH Professional and Toni brainstormed a list of possible solutions to past and present situations;3)Stress Relievers-IIH QP and Toni brainstormed ways for Toni to relax that fit her personality and interest such as writing, running, hanging out with friends and compared them to a list of stress relievers that she may practice that

are not as positive as those examples such as fighting, destroying property, disrupting her class. IIH QP taught Toni relaxation skills that she can use when feeling frustrated, angry, or overwhelmed. IIH QP reviewed unhealthy coping strategies such as explosive or angry behavior, self-mutilation, drugs, alcohol, tobacco use, school avoidance, sexually inappropriate behavior. IIH QP and Toni reviewed the benefits of relaxation: 1) once learned are versatile because they can be used anytime, anywhere, and for practically any situation; 2) they don't require any special equipment and can be modified for the individual user; 3) empowers teens to feel that they have some control over their emotions; 4) simple enough to teach that teens can easily share them with others. IIH QP taught Toni 3 basic types of relaxation techniques by modeling each for Toni to provide a visual of each technique such as 1. Progressive Muscle RelaxationFocus on one muscle at a time, alternately contracting and relaxing the muscle. 2.Guided Imagery-choose a relaxing scene at the focal point; location teen finds personally meaningful and calming. Utilization of all five senses. 3.Controlled Breathing-slow purposeful breathing that helps increase calmness and relaxation; breathe in through nose for 3-4 seconds and out the mouth for 6-8 seconds for a period of 5 to 10 minutes. IIH QP prompted Toni to practice each technique and provided corrective feedback. -------------------------------------------------------------------------------------------------------------------------------------.IIH Professional taught Communication skills in order to increase their family and peer interactions and relationships. IIH Professional taught Communication Builders to Toni's mother in order to help her communicate effectively with her Toni and her siblings by exploring feelings, identifying problems, and move kids to problem solving. IIH Professional provided more productive communication options to counteract actions of the parents that serve as Communication Blockers by having her process the productive options by listing and discussing each following option: 1.) Reflective listening-listen to what is being said and try to reflect back both content and feelings such as "It sounds like with everything going on, you've been really overwhelmed lately." Demonstrates empathy, and helps develop trust and increases chance of kids wanting to talk further; 2) Questioning-ask pointed questions to help kids explore certain ideas further. Helps them develop insight and self awareness and get them to have a better understanding of why they are choosing certain actions and behaviors; 3) Goal Setting-empower kids by having them form their own goals, "What would you like to be different?", helps them take ownership of problem solving and find the solution; 4) Problem Solving-Kids deal with similar problems, help them identify skills they already possess and apply them to new situations "How have you managed your anger with friends in the past?",

help them to brainstorm options; 5) Evaluation-Follow-up after the solution is implemented. Use reflective listening skills again to encourage child to share their experience with you. IIH Professional had Toni's mother list what she presently does to help her children problem solve when they come to her with an issue and compare that list with communication builders list to assess what she could do differently. IIH Professional and Toni's mother role played scenarios offered with skill building lesson to practice techniques learned. IIH Professional taught Communication Skills to Toni and her family in order to help them develop and implement anger management techniques, and improve communication skills to decrease angry outburst and increase positive interaction among family members.

IIH Professional taught Toni's mother how to help her children with effective emotional management through modeling, reflective listening, scaling techniques and "I" messages to help Toni and her siblings accurately label the type and intensity of their feelings by:

IIH Professional taught the following steps to Toni's mother by having her write down each step to refer back to when needed: 1) Avoid Fixing-(Attempts to give quick fixes by offering solutions, gives message that they are incapable of solving their own problems;2)Modeling-(Kids take cues from you, get in habit of using "I messages" such as "I'm feeling overwhelmed at work."; 3)Use reflective listening skills (Your kid needs to know that they are heard; listen closely for both content and the feeling behind content, then paraphrase what you hear back to check for accuracy.); 4)Scaling Technique-(When a kid feels heard, they're more likely to feel safe and explore issue further with you. Ask them to rate level of feelings on scale of 1-10; 5) I Messages-(Teach them to express their feelings by saying "I feel angry about...)

IIH Professional helped Toni's mother to process ther information by engaging her in a role play scenarios that allowed her to practice these techniques.

IIH Professional demonstrated the tone of voice that Toni's mom should use, moderate tone, no yelling because that would only alienate Toni and her siblings and cut of lines of communication.

IIH Professional also demonstrated body language that should be used when communicating with her children so that they will perceive your demeanor as you're

really interested and listening by making eye contact, displaying good posture, and pleasant look; avoid making faces in regards to their statements. IIH Professional taught Communication Skills to Toni and her family in order to help them develop and implement anger management techniques, and improve communication skills to decrease angry outburst and increase positive interaction among family members.

IIH Professional taught Toni's mother how to help her children with effective emotional management through modeling, reflective listening, scaling techniques and "I" messages to help Toni and her siblings accurately label the type and intensity of their feelings by:

IIH Professional taught the following steps to Toni's mother by having her write down each step to refer back to when needed: 1) Avoid Fixing-(Attempts to give quick fixes by offering solutions, gives message that they are incapable of solving their own problems;2)Modeling-(Kids take cues from you, get in habit of using "I messages" such as "I'm feeling overwhelmed at work."; 3)Use reflective listening skills (Your kid needs to know that they are heard; listen closely for both content and the feeling behind content, then paraphrase what you hear back to check for accuracy.); 4)Scaling Technique-(When a kid feels heard, they're more likely to feel safe and explore issue further with you. Ask them to rate level of feelings on scale of 1-10; 5) I Messages-(Teach them to express their feelings by saying "I feel angry about...)

IIH Professional helped Toni's mother to process ther information by engaging her in a role play scenarios that allowed her to practice these techniques.

IIH Professional demonstrated the tone of voice that Toni's mom should use, moderate tone, no yelling because that would only alienate Toni and her siblings and cut of lines of communication.

IIH Professional also demonstrated body language that should be used when communicating with her children so that they will perceive your demeanor as you're really interested and listening by making eye contact, displaying good posture, and pleasant look; avoid making faces in regards to their statements.

-------------------------------------------------------------------------------------------------------------------------------------IIH Professional taught Communication skills in order to increase their family and peer interactions and relationships.

IIH Professional taught Communication Builders to Toni's mother in order to help her communicate effectively with her Toni and her siblings by exploring feelings, identifying problems, and move kids to problem solving.

IIH Professional provided more productive communication options to counteract actions of the parents that serve as Communication Blockers by having her process the productive options by listing and discussing each following option: 1.) Reflective listening-listen to what is being said and try to reflect back both content and feelings such as "It sounds like with everything going on, you've been really overwhelmed lately." Demonstrates empathy, and helps develop trust and increases chance of kids wanting to talk further; 2)Questioning-ask pointed questions to help kids explore certain ideas further. Helps them develop insight and self awareness and get them to have a better understanding of why they are choosing certain actions and behaviors; 3)Goal Setting-empower kids by having them form their own goals, "What would you like to be different?", helps them take ownership of problem solving and find the solution; 4)Problem Solving-Kids deal with similar problems, help them identify skills they already possess and apply them to new situations "How have you managed your anger with friends in the past?", help them to brainstorm options; 5)Evaluation-Follow-up after the solution is implemented. Use reflective listening skills again to encourage child to share their experience with you.

IIH Professional had Toni's mother list what she presently does to help her children problem solve when they come to her with an issue and compare that list with communication builders list to assess what she could do differently.

IIH Professional and Toni's mother role played scenarios offered with skill building lesson to practice techniques learned. -----------------------------------------------------------------------------------------------------------------------------------------

IIH Professional taught Toni Coping and Self Management Skills in order to improve coping skills to deal with life circumstances. IIH Professional taught Toni techniques for effective emotional management by helping him to develop skills in communication, problem solving and relaxation. IIH Professional had Toni process the following steps by writing them down to help retain information and so he could refer back to the following skills during times of extreme stress: 1)Talking It Out-use tools to express yourself appropriately through the use of "I Messages", identifying feelings, scaling to be able to discuss the intensity of your feelings. IIH Professional had Toni identify several people that he feels comfortable discussing problems with so that he can be able to validate her feelings with attention and time from a valued adult; 2)Brainstorming-IIH Professional and Toni brainstormed a list of possible solutions to past and present situations;3)Stress Relievers-IIH Professional and Toni brainstormed ways for Toni to relax that fit her personality and interest such as wrestling, video games, boy scouts, and compared them to a list of stress relievers that he may practice that are not as positive as those examples such as fighting, destroying property. ---------------------------------------------------------------------------------------------------------------------------------IIH Professional taught Toni relaxation skills that he can use when feeling frustrated, angry, or overwhelmed.

IIH Professional reviewed unhealthy coping strategies such as explosive or angry behavior, self-mutilation, drugs, alcohol, and tobacco use, school avoidance.

IIH Professional and Toni reviewed the benefits of relaxation: 1) once learned are versatile because they can be used anytime, anywhere, and for practically any situation; 2) they don't require any special equipment and can be modified for the individual user; 3) empowers teens to feel that they have some control over their emotions; 4) simple enough to teach that teens can easily share them with others.

IIH Professional taught Toni 3 basis types of relaxation techniques such as 1) Progressive Muscle Relaxation-Focus on one muscle at a time, alternately contracting and relaxing the muscle. 2) Guided Imagery-choose a relaxing scene at the focal point; location teen finds personally meaningful and calming. Utilization of all five senses.

3.Controlled Breathing-slow purposeful breathing that helps increase calmness and relaxation; breathe in through nose for 3-4 seconds and out the mouth for 6-8 seconds for a period of 5 to 10 minutes.

IIH Professional demonstrated all three techniques for Toni, then had Toni model each. Toni. IIH Professional taught Toni and her grandmother how to increase their peer and grandmother interactions and relationships by teaching them 3 Conflict Resolution Styles to help them Identify their style and determine whether their style works for or against their grandmother.

IIH Professional taught Toni and her grandmother 3 Conflict Resolution Styles and their differences in order to teach them more effective strategies such as 1.)The Passive Approach (trouble communicating and advocating for one's needs due to fear resulting from low self-worth or lack of good communication skills; more likely to have problems making friends, often bullied); 2) The Aggressive Approach(Often confrontational and intimidating in personal interactions; uses threatening verbal or body language and often don't care about the personal needs of others; sole goal is to get what they want, cooperation is difficult; 3)Assertive Approach (Gets needs met while respecting the needs of others; knows how to cooperate and compromise, goal to achieve win-win outcome).

IIH Professional modeled assertive problem-solving to teach Toni and her grandmother how to handle conflicts respectfully yet assertively. IIH Professional verbalized steps to enhance learning.

IIH Professional also engaged the grandmother in role-play session on how to handle conflicts. IIH Professional provided guided practice in teaching Toni and her grandmother how to develop respectful yet productive responses to conflict situations. IIH Professional helped the grandmother recognize and interpret and process the subtleties of feelings and intent in verbal expression during the roleplay. ---------------------------------------------------------------------------------------------------------------------------------------IIH Professional taught Communication skill to Toni and her family in order to teach them how to develop and implement anger management techniques, and

improve communication skills to decrease angry outburst and increase positive interaction among family members.

IIH Professional taught Toni's parents Communication skills by teaching them strategies for Talking to Teens such as Communication Blockers-Mistakes to Avoid When Talking to Teens 1)Don't Minimize the problem because children tend to perceive that you are "blowing them off" or that you "don't get it" and can lead to teens feeling misunderstood and isolated; 2)Don't tell kids how they should feel such as you shouldn't let ther bother you" or "You know you don't really feel that way" because it invalidates their feelings and perspective, makes them feel disrespected, and unlikely to share things with you. They may also wind up feeling depressed for having the "wrong" feelings; 3) Don't offer false reassurance regarding things beyond your control such as "Everything will work out for the best!" Ther modeling of hopefulness and a positive attitude may only promise a simplistic and unrealistic "quick fix" Which minimizes the problem and leaves the child without any options; 4)Don't blame them for the problem such as "You must have done something to make him say that to you." because even though they may have some responsibility in the problem, the initial stages of the disclosure are them expressing their feelings in an attempt to find understanding and empathy. Instead work towards problem solving which may involve children taking ownership after wards, assigning responsibility to early can be perceived as blaming and can be one of the quickest ways to shut down communication.

IIH Professional prompted Toni's parents recall times and situations in which these communication blockers made a situation worse and brainstorm what could have been done in hindsight that might have resolved a problem or situation effectively.

dIIH Professional helped Toni's parents practice these techniques by role playing scenarios in which they were able to communicate without using communication blockers, but effectively resolved situations using appropriate communication techniques. ---------------------------------------------------------------------------------------------------------------------------------------IIH Professional taught Toni coping skills in order to deal with life circumstances such as peer pressure.

IIH Professional taught Toni and her sister the Top Ten Refusal Skills for Teens in order to teach him and her sister how to respond assertively to peer pressure.

IIH Professional discussed and engaged Toni and her sister in making a poster board of the following responses to peer pressure; 1) Make a joke-sometimes humor can be the best way to respond to a situation to lighten a serious mood; divert attention; 2)Give a reason why it is bad idea-can lead to other bad choices or serious consequences; 3) Make an excuse why you can't and stick to it-you have to be somewhere at a certain time, or your mom will kill you; 4)Just say no, plainly and firmly without a lot of arguing and explaining; 5)Suggest an alternative activity-offer everyone an out by providing other options; 6)Ignore the suggestion-pretend you didn't hear it and change the topic; 7)Repeat yourself if necessary-more than once on more than one occasion; 8)Leave the situation-if you don't like where things are headed, take off; 9)Thanks, but no thanks-be polite, but you still are not interested; 10)The power of numbers-make a pact with your friends to stick to your guns;"we" can feel stronger than "I".

IIH Professional engaged Toni and her sister in some typical situations with teens and pre-teens, and had them practice using each one of the 10 refusal skills in order to develop assertiveness and confidence when interacting with their peers. ---------------------------------------------------------------------------------------------------------------------------------------IIH Professional taught Coping and Self Management Skills to Toni in order to help him deal with life circumstances.

IIH Professional taught Toni's mother how to calm Toni down during conflicts by teaching her 10 strategies for De-escalating Emotional Teens. 1) Give time to regroup-stop talking, stop trying to prove a point, and take a break; 2) Give Space to Calm Down-give physical distance with supervision, give room to pace, punch pillow, vent, and otherwise express themselves; 3) Remove any audience presentdifficult to get upset teen to leave the room, easier to remove bystanders b/c kids will perform for other kids; 4) Align with the Teen-avoid confrontation, win/lose positioning, calm will come quicker when teen views the adult as ally rather than enemy; 5) Stay Respectful-avoid sarcasm and belittling comments; 6)Use reflective listening-repeat teens statements back to them, makes them feel listened to; 7) Mirror emotions-identify emotions; 8) Let kids save face-resist compulsion to get the last word, kids need to feel some sense of control; 9) Save lessons for Later-wait until things are calm for a while before making your point; 10)Swap out Adultssometimes adult that was present cannot be the adult that helps solve the problem.

IIH Professional prompted Toni's mother to write the list of strategies in order to refer back to them when needed. IIH Professional lead Toni's mother in a discussion about the strategies and her confidence in implementing them with Toni and her sister.

IIH modeled the ten strategies for Toni's mother and as well as appropriate body language in order to give Toni's mom an auditory and visual perspective.

IIH role played scenarios of conflict with Toni and her sister to further provide Toni's mother with examples of how the strategies should be implemented IIH Professional taught Toni and her sister Socialization Skills in order to teach them how to interact with their peers. IIH Professional taught Toni and her sister how to get along with each other and their peers by teaching Strategies for Reducing Conflict and Promoting Cooperation at Home such as 1) Positive Interdependence-working together in her or her own role (sharing supplies for a project, or having responsibility for a portion of a chore that is only completed when all portions are finished; 2) Compromise (take turns, look for common ground, discuss final alternatives and make mutual decision); 3) Face to Face Interaction-use toys or play materials that require sharing, taking turns, listening, talking, and collaborating( role-playing games such as playing house, restaurant, dress up ); 3) Agreeing to Disagree-express and retain their own opinion on things without arguing, fighting, or otherwise becoming disagreeable; Reflection-ask questions such as How did you both decide that? in order to encourage their childrens active participation in the choices that lead to cooperation, collaboration and compromise. IIH Professional facilitated a structure activity (restaurant game) in order to get them to focus on particular social skills such as taking turns, active listening, and encouraging others. IIH Professional modeled those skills in the role play activity to help Toni and her sister understand what those skills look and sound like. IIH Professional praised Toni and her sister when they were able to demonstrate appropriate social skills. IIH Professional taught Tonis parents how to implement these skills by reviewing these strategies with them to help them promote harmony amongst Toni and her siblings in the home. IIH Professional prompted Tonis parents to write down the strategies and place them in an accessible place in order to refer back to and review strategies on a continuous basis. IIH Professional continued to role play different scenarios that may occur between Toni and her siblings and helped Tonis parents implement the different strategies to preempt the conflict or resolve it once it has begun. IIH Professional taught Tonis sister Coping and Self Management skills in order to help her build positive self esteem that will promote increase social interaction with her peers.

IIH Professional facilitated activities to promote Tonis sisters ability to feel good about herself such as making an affirming list in her journal. IIH Professional helped Tonis sister brainstorm the following affirmations: 1) five of your strengths; 2) five things that you admire about yourself; the five greatest achievements in your life so far; 20 accomplishments; 10 ways to you can treat or reward yourself that dont include food and dont cost anything; 10 things you can do to make yourself laugh; 10 things you could do to help someone else; 10 things that you do that make you feel good about yourself. IIH Professional assisted Tonis sister in making a celebratory scrapbook of herself at different ages, writings she enjoys, mementos of things she has done and place she has been, cards she received. IIH Professional assisted Tonis sister in setting up a place in her room that celebrates her so that she can look at them every day to bolster her self-esteem. IIH Professional facilitated an appreciation exercise on a sheet of paper that began, I like________(your name) because: IIH Professional prompted Tonis sister to get her family members to write appreciative statements about her on the sheet of paper. IIH Professional advised Tonis sister not to argue with what her family has written and too just accept it. IIH Professional encouraged Tonis sister to read her sheet over and over again and keep in place where she would see it often. IIH Professional helped Tonis sister create a Self Esteem Calendar. IIH Professional assisted Tonis sister in scheduling into each day some small thing that you enjoy doing, such as playing with her animals, and playing video games. IIH Professional taught Toni and her sister Interpersonal Skills in order to help them deal with life circumstances. IIH Professional taught Toni and her sister Decision Making Strategy for Teens in order to teach them How to Make Good and Thoughtful Choices by weighing their options carefully before making important decisions. IIH Professional prompted Toni and her sister define specific problems (conflicts with Mom, conflicts with peers, inability to control angry impulses) and brainstorm all of the possible choices and write the problems and the choices down to ensure that they are clear and that every possibility has been considered. IIH Professional taught Toni and her sister how to process possible choices by thinking about the consequences (both good and bad) of each choice. IIH Professional prompted Toni and her sister to list the consequences as well. IIH Professional taught Toni and her sister how 1) identify which option has more positive consequences or fewer negative consequences; 2) evaluate each consequence independently and rate each outcome on a scale from 1 to 5 in order to weight them when it comes time to evaluate each option; eliminate options that are unethical or conflict with values.

IIH Professional engaged Toni and her sister in role play of scenarios to help them imagine what the outcome would be like after the decision to a problem has been made. IIH Professional prompted Toni and her sister to write and answer in their

journal the following questions as they were imagining each outcome as they went through each role play: 1) What would be the difference? What would be better or worse? What feelings are involved? Does imagining ther possible future bring about peaceful feelings, anxiety, or happiness? IIH Professional prompted Toni and her sister to do ther for each of the possible options in the decision. IIH Professional also taught Toni and her sister another option to making decisions such as gathering information by 1) seek out information from others who have dealt with similar issues in the past; 2) Ask questions such as What helped you to decide? or What additional information is here? because it is more helpful to ask questions about the decision making process than for actual advice (may help trigger idea or an angle not originally considered taking into consideration that their ideas and values may be different); 3) after gathering the information, select the choice that seems to be the best one. IIH Professional prompted Toni and her sister to write down the reasons they selected their choice above all others, to help them process their decision; 4) IIH Professional helped Toni and her sister create an action plan listing the steps needed to complete the task. IIH Professional taught Tonis mother parenting skills in order to help her Toni and her sister Coping and Self Management Skills that will teach them how to deal with life circumstances. IIH Professional taught Toni and her sister how to develop strong self esteem by teaching them experiences and relationships that promote a healthy sense of self. IIH Professional taught Tonis mother terms in relation to self esteem to provide a foundation base for the strategies that she will learn to implement during ther session. IIH Professional helped Tonis mother search the following terms on the internet: 1) Self Concepts-The mental image or perception that one has of oneself, e.g. a child with a limited sports experience may have a self-concept that includes a lack of athletic ability; an observation, who the child sees themselves to be. 2) Selfesteem-reflects a person's overall evaluation or appraisal of her or her own worth, e.g. if the child values athleticism, or is surrounded by people who do, then he/she is likely to have a low opinion of who he/she is based on her perceived lack of competence (self-concept). 3) Self-Efficacy-belief in one's capabilities to achieve a goal or an outcome (direct result of self-esteem). IIH Professional educated Tonis mother on the four sources from which self-efficacy may be primarily derived 1) past experiences with success or failure; 2) encouragement from a trusted adult; 3) physiological cues, including the anxiety that occurs when faced with a difficult task and the exhilaration that comes with succeeding at it; 4) modeling of can-do attitude by ones peers. Self-efficacy also effects, motivation, initiative, effort, persistence, and the overall willingness to try new activities or learning tasks. IIH Professional helped Tonis mother process ther information by relating terms and examples to her feelings of inadequacy in areas of her life and how her ideas about herself contribute to those feelings. IIH Professional provided counseling and positive feedback to Tonis mother as she discussed her feelings about herself. IIH Professional taught the following strategies in regards to raising self efficacy and self esteem in Toni and her sister: 1) help set short and long term goals, discussing

milestones they can use to gauge their growth and smaller successes; 2) be specific in drawing attention to small accomplishments, and helping Toni and her sister see how they can lead to larger successes; 3) Avoid hollow praise; 4) if Toni and her sister are unsuccessful, talk with them about how they approached task (what they did well and what they will work on for the next time); 5) build strength through cooperative learning activities that allow them to have a part in a group success; 6) encourage friendships with other children who have a can-do attitude, and provide experiences that allow Toni and her sister to be the expert. IIH Professional prompted Toni and her mother to write these strategies in order to be able to refer back to them on a daily basis. IIH Professional role played scenarios with Tonis mother to teach her how to implement these strategies in her home. IIH Professional taught Toni Communication Skills to teach him how to develop positive relationships with her peers. IIH Professional taught Toni how to Develop Social Communication Skills to help him build healthy relationships with other teens by teaching him strategies that will decrease conflicts. IIH Professional taught and modeled appropriate social behavior such as empathy, sharing, taking anothers perspective, and reading body language in order to give Toni a visual of such behaviors. IIH Professional prompted Toni to demonstrate the appropriate social behaviors learned. IIH Professional debriefed what was modeled and why in order to enhance Tonis learning experience. IIH Professional engaged Toni in a role-playing session in order to prepare him for the scenarios that were specific to him to prepare him for the next time such as 1) turning down a cigarette, asking someone out on a date, or offering help to someone. IIH Professional allowed Toni to have a turn playing both parts. IIH Professional helped Toni learn how to identify social cues in order for him to read body language, facial expressions, vocal and other gestures which will help him identify possible messages by demonstrating those cues and have Toni guess what message I was trying to send with each cue (happy, angry, frustrated, sad, anxious). IIH Professional and Toni viewed clips of people to decipher the messages that their social cues were giving by Questioning in order to build empathy such as What do you think it might mean when she makes that face?, Why do you think it might mean when she makes that face?, Why do you think he might be turning away like that?, Why do you think he was upset by what you said? IIH Professional provided positive and negative feedback in order to help Toni identify areas where he needs improvement. IIH Professional engaged Toni in a journaling session to see if he could come up with some alternatives independently. IIH Professional taught Tonis mother parenting skills related to Communication Skills in order to decrease the number of conflicts that occur in their household. IIH Professional taught Tonis mother How to Find Relief in Communication by developing better conflict management and Resolution Skills that are essential.

IIH Professional taught Tonis mother successful strategies to reduce feelings of anger and conflict by teaching the following essential communication skills such as 1)Taking time to set up a one on one setting with minimum distractions for communication; 2) Reflect teenager statements to show understanding such as, I hear you saying youre mad about the change in your curfew.; 3) Use I statements when talking about feelings about the conflicting situation; 4) Asking teenagers to repeat the parents statements to show understanding; 5)Model selfcare which includes taking time to allow anger to diffuse before attempting to resolve issues. IIH Professional taught Tonis mother how to reduce frustration with conflict resolution by defining conflict resolution (process in which the goal is to have both sides walk away satisfied the issue has been addressed and fairly served; win-win outcome). IIH Professional provided Tonis mother with strategies that parents and teenagers need to follow in order to engage effectively engage in conflict resolution skills: 1) Find a quiet place and convenient time for the discussion; 2) both parties state what they believe the conflict to be; 3) Once the conflict is identified, the parties generate solutions to the conflict by brainstorming; 4) The parties each express their preferred outcome respectfully; 5) The parties each agree to a common solution, both giving up benefits and gaining benefits to meet the goal of resolution. IIH Professional had Tonis mother list the Communication and Conflict Resolution strategies as a learning tool which she can refer back to when needed. IIH Professional engaged Tonis mother in a role play activity to review and practice the implementation of Communication and Conflict Resolution strategies. IIH Professional met with Team lead/LPC to discuss the family's presenting issues and further develop treatment plan for Toni and her family. IIH Professional taught Anger Management and Communication Skills in order to help Toni and her family to develop and implement anger management techniques, and improve communication skills to decrease angry outburst and increase positive interaction among family members.

IIH Professional taught Toni's Parents Skills for Managing Oppositional Youth by providing intervention "Working with Defiant and Angry Teens".

IIH Professional taught the following techniques to Toni's mother 1) Building Positive Relationships with Defiant Teens-key to getting defiant teens to respond by listening to kids, show genuine care, show respect; 2) Avoiding Power Struggleslose/lose situations that damage relationship. Make rules simple and structured, don't make demands, gently remind them of rules and offer a choice where possible, watch tone of voice, body language, and word choice, don't convey an attitude of disrespect or anger; 3) Teach Positive Skills-Social and Communication Skills-reading body language and tone of voice, maintaining friendships, and resolving conflicts; Positive Decision Making-help teens learn how to think through

the steps of making choices, predicting and analyzing the possible consequences of their actions.

IIH Professional taught Toni's mother how to implement these strategies by using reflective listening skills. IIH Professional prompted Toni's mother to role play real life scenarios to assist her with practicing implementing reflective listening skills on a daily basis.

IIH Professional helped Toni's mother develop an action plan to include strategies learned in session for getting Toni and her siblings back on track when Toni or her siblings become defiant and angry. IIH Professional researched interventions related to Parenting skills for parents with teenagers with emotional problems to help Toni's mother relate better to her son and her presenting issues instead of continuing to meet Toni's anger with anger.

IIH Professional taught Coping and Self Management Skills to help Toni and her family will develop and implement anger management techniques, and improve communication skills to decrease angry outburst and increase positive interaction among family members.

IIH Professional taught Toni's mother how to Manage Power Struggles with Teens by providing six strategies for avoiding and reducing arguments with kids 1)Being Consistent-Adults who do what they say they will, and enforce their rules each and every time, will have less issues with power struggles than those who dont; 2)Staying Calm-The goal should be to stay calm, and help the child stay (or regain) calm;use the traditional strategies to stay calm, such as counting to ten, taking deep breaths, using positive self-talk, and temporarily leaving the situation; 3) Offering Reasonable Choices-Sometimes, giving kids some limited choices can help them feel a sense of control and, often more importantly, save face; 4)Staying Respectful-meanness, sarcasm, insults, and other jabs are not going to win the battle or the war. What they will do is diminish and damage the adults relationship with the teen,avoid switching the focus of the situation onto the teens attitude; that only dilutes the importance of the issue at 43wsz vbnmkl,.mhand;5)Keeping Consequences Proportionate-Wildly irrational consequences are meaningless to teens because they know they wont stick. Try hard to keep the consequences proportionate to what has happened; 6)Keep Consequences EnforceableConsequences that the adult has complete control over (allowance, privileges, etc.) are better because theres less risk of another fight when the consequences is implemented.

IIH Professional prompted Toni's mother to discuss recent events that presented a power struggle between her and Toni and how and if she resolved the issue.

IIH Professional and Toni's mother brainstormed alternative options that Toni's mother could present that related to the strategies presented in the intervention session. IIH Professional taught Coping and Self Management Skills to help Toni and her family improve coping skills to deal with life circumstances.

IIH Professional taught Toni's mother How to Get Kids to Do Chores by providing strategies for parents who want their children to help around the house by 1) Train Children to do Chores-for children that are old enough to read, provide written step by step instructions to ensure there are no questions about what needs to be done, and keep chores more basic for children who are not yet old enough to follow written instructions; Model Good Behavior-Parents need to make sure to do whatever it is they expect of their children; Use a Timer to Motivate Kids When Doing Household Chores-A game of "beat the clock" can make chores more fun as children work hard and fast in order to get a job done before the timer goes off, make it fun; Reward Good Behavior-Offer verbal praise, Provide an allowance that is based on chores that are done, Allow extra privileges such as staying up late, watching a favorite television show, or having friends over when chores have been done well.

IIH Professional role-played with Toni's mother in order to practice strategies that were taught.

IIH Professional modeled appropriate body language and tone of voice in order to help Toni's mother lessen the negative response that Toni gives when chores are asked to be completed. IIH Professional researched interventions related to developing anger management skills to address DaQujuan's aggressive behavior.

IIH professional taught DaQujuan and her family Coping and Self Management Skills in order to address DaQujuan's behaviors of aggression that are being displayed at home and at school as follows:

-taught that Anger and Aggression are not the same thing; two very different forms of behavior.

-As a result anger is seen as being something bad or something that should not be shown to avoid upsetting, rejecting or hurting others; anger is a normal emotion. -More effective ways of displaying anger; utilization of relaxation skills and techniques (body scanning, deep breathing, progressive muscle relaxation, cue controlled forms of relaxation and learning to visualize a special, safe place). -Utilization of Meditation-related exercises that involves mindfulness (learning to stay in the present moment), yoga, or listening to mindfulness CD. -Create anger coping thoughts (positive statements used to challenge negative thoughts associated with triggers or events that one may find stressful or anxiety provoking such as getting yelled at by authority figure, not being able to participate in an activity, not being able to understand a homework assignment). -Examples of coping thoughts ("Ther is annoying but I can let it go."; "Getting upset will not help so I will remain calm."; "She is entitled to her own opinion as am I.") -Regular exercise-release of feel good hormones know as Endorphins (natural mood booster) such as tennis, biking, running.

IIH Professional demonstrated/modeled techniques for DaQujuan and her family to provide visual of techniques that were not familiar to them.

IIH Professional assisted DaQujuan and her family in developing a relaxation regiment that they could utilize on a weekly basis. ------------------------------------------------------------------------------------------------------------------------------------

-------------------------------------------------------------------------------------------------------------------------------------IIH Professional taught Anger Management skills and Coping skills to Toni in order to help him develop and implement anger management techniques, and improve communication skills to decrease angry outburst and increase positive interaction among family members. IIH Professional taught Conflict Resolution strategies to help Toni resolve differences in order to continue with a relationship in an effective way. IIH professional taught Toni the basic truths of conflict resolution: 1)conflict is natural and inevitable, 2)perspectives are not right or wrong, 3)there are many ways to manage every conflict, 4)all people need control, respect, fairness, and space, 5) we often have the ability to influence others; we rarely have the ability to control them.

IIH Professional taught Toni the different types of conflict, 1)Intrapersonal-w/in the person (moral dilemma, making a decision; 2) Interpersonal-between two or more indiv. (siblings disagreeing, boyfriend and girlfriend arguing); 3) Intragroup-between indiv. w/in a group (club raising money and cannot agree how to allocate it); 4)Intergroup-between groups (clubs disputing who gets to use a particular facility or event.

IIH professional also taught Toni the positive and negative aspects of conflict: Negative Aspects: (can lead to negative feelings between the parties involved, can lead individuals or group to close themselves off from one another (sets a bad precedent for future dealings with the conflicting party)can waste time and energy if poor conflict style is used). Positive Aspects: Forces the parties involved to examine a problem and work toward a solution, can help people to gain new information and new ways of looking at things -can force us to explore new ideas, when it occurs in groups, working together to solve a problem can increase cohesiveness within group, confronting and wanting to solve a problem indicates a concern, commitment, and a desire to preserve the relationship.

IIH Professional engaged Toni in role-playing scenarios regarding the different types of conflicts and the negative and positive aspects that may result from the types of conflicts. IIH Professional taught Anger Management skills and Coping skills to Toni in order to help him develop and implement anger management techniques, and improve communication skills to decrease angry outburst and increase positive interaction among family members.

IIH Professional taught Conflict Resolution strategies to help Toni resolve differences in order to continue with a relationship in an effective way.

IIH Professional continued to teach Toni conflict resolution skills to Toni in regards to Making it Better, Making it Worse: IIH Professional taught Toni that conflict will usually Escalate when: Bystanders become involved and take sides, one or both parties feels threatened by the other, there is no interest or investment in maintaining the relationship, there is an increase in the acting out of anger, fear, or frustration (indirect expression), important needs involved are not acknowledged or met. IIH Professional also taught Toni that conflict will usually Decrease when: those involved focus on the problem instead of each other, emotions of anger, fear and frustration are expressed directly rather than demonstrated indirectly, threats are eliminated, needs are openly discussed and acknowledged.

IIH Professional taught Toni the following additional conflict styles along with definitions of each, and the potential Uses and Limitations. IIH Professional modeled each style to provide Toni with a visual of each for frame of reference. 1. Controlling-pursuing personal concerns at anothers expense (hard bargaining). Uses: when immediate attention is needed; when you believe your correct Limit: intimidates people so they are afraid to admit problems and give important info 2.Collaborating-working w/someone by exploring your disagreement, generating alternatives, and finding a solution which satisfies both parties (negotiating). Uses: learning from anothers perspective, helpful when you need to address concerns of all parties. Limit: not as helpful for minor decisions or when time is limited. 3. Compromising-seeking middle ground (splitting the difference). Uses: when all else fails, for fast decision making on minor disagreements. Limits: losing sight of larger issues and values, may not please anyone. 4. Accommodating-yielding to another persons point of view; paying attention to the concerns of others, neglecting your own (soft bargaining). Uses: when you see that you are wrong, wanting harmony towards a more important issue. Limits: you may not ever get your concerns addressed. 5. Avoiding-not addressing conflict, withdrawing from the situation or postponing the issue (leaving well enough alone). Uses: when confronting is too dangerous or damaging; is unimportant; needs to be cooled down. Limits: issues may never get addressed. IIH Professional prompted Toni to recall 5 past conflicts and identify their conflict styles and journal each. IIH Professional helped Toni brainstorm alternatives for becoming involved in a conflict. --------------------------------------------------------------------------------------------------------------------------------------IIH Professional taught Anger Management skills and Coping skills to Toni in order to help him develop and implement anger management techniques, and improve communication skills to decrease angry outburst and increase positive interaction among family members.

IIH Professional taught Conflict Resolution strategies to help Toni resolve differences in order to continue with a relationship in an effective way.

IIH Professional continued to teach Toni conflict resolution skills to Toni in regards to Improving Conflict Resolution Skills which is dependent upon good communication skills, and being an active listener.

IIH Professional taught Toni the Things that Impede Communication and prompted him to make a list of the following: 1. ordering someone to think/do something; 2. threatening; 3. preaching/lecturing; 4. judging; 5. providing advice/solutions that were not requested/desired; 6. forcing your opinions onto someone.

IIH Professional taught Toni the Things that Improve Communication: 1. openmindedness; 2. accepting different opinions as valid; 3. seeing others as equals with equal right to be heard; 4. showing empathy and respect; 5. listening carefully and actively.

IIH Professional also taught Toni the Conflict Resolution Process to equip him with all the skills necessary to be successful when managing her anger such as: 1.Before the confrontation (to do on your own). Ask yourself: What specifically concerns me about ther conflict?; How does ther affect me?; Why is ther important to me?; What would make ther situation better for me? IIH Professional prompted Toni to answer these questions regarding her latest conflict with her mother. 2. During the Actual Confrontation-Set the tone State positive intentions and have a positive attitude; Acknowledge and validate the other party. 3. Discuss and define the problem Take turns, with each party getting equal time to speak and each party actively listening. Use productive listening and speaking techniques Identify each sides interests and needs. If necessary, discuss assumptions, suspicions, and values. 4. Summarize new understanding a.) Brainstorm alternative solutions Determine the advantages and disadvantages of each possible solution; consider consequences; be realistic. Choose solutions that are mutually satisfactory to all parties. Make sure the solutions are specific and balanced/fair. b.) Plan for follow-up Agree to evaluate the solutions and the consequences thereof at a later date, to make sure the solutions are working for all parties. ----------------------------------------------------------------------------------------------------------------------------------------IIH Professional taught Behavior and Anger Management skills in order to decrease or terminate temper tantrums and replace with controlled, respectful compliance with directions from authority figures.

IIH Professional taught Quebin that there are three different kinds of anger 1) you may feel just a little irritated; 2)you may feel annoyed; or 3) you may feel like you have a violent storm inside of you (furious).

IIH Professional read Quebin a story about a boy that responded the same way to all the things that bothered him, and people began to think of him as an angry kid and did not understand what he needed or wanted in order to help him identify how he may react when he feels different types of anger and how people may be perceiving him based on her reactions.

IIH Professional provided Quebin with an activity in which he needed to complete several sentences that will help him to remember that there are different kinds of anger and there are different ways to react.

IIH Professional provided Quebin with another activity in regards to the different kinds of anger in which he was asked to 1) name five "little" emotions?; and 2) how to express each of these emotions.

IIH Professional made collateral contact with Quebin's mother in order to gather information in regards to her behavior in school over the past week.

IIH Professional taught Behavior and Anger Management skills in order to decrease or terminate temper tantrums and replace with controlled, respectful compliance with directions from authority figures.

IIH Professional reviewed with Quebin that there are three different kinds of anger 1) you may feel just a little irritated; 2)you may feel annoyed; or 3) you may feel like you have a violent storm inside of you (furious).

IIH Professional revisited the activity from the previous day in which Quebin was asked to 1) name five "little" emotions?; and 2) how do you express each of these emotions? IIH Professional prompted Quebin to ask the following questions as well 3) name five "big" emotions; 4) how do you express each of these emotions? 5) what is one thing people do when they are furious that never helps?; 6) what is one thing you can do when you are furious that almost always helps?

IIH Professional and Quebin role played different scenarios in which Quebin events took place that triggered different angry responses from Quebin. Quebin played

himself and professional role played as mother, teacher, and community authority figure. IIH Professional modeled appropriate behavior for Quebin in order to provide visual of how appropriate behavior looks and when it should be implemented during each scenario and carried over into daily activities.

IIH Professional made collateral contact with IIH team members in order to discuss treatment plan, mother's lack of commitment, mother's expectations, additional resources that may help the family and Quebin to be successful.

IIH Professional taught Behavior and Anger Management skills in order to decrease or terminate temper tantrums and replace with controlled, respectful compliance with directions from authority figures.

IIH Professional provided activity titled "You Have Anger Buttons". IIH Professional taught Quebin that when you know your anger buttons (the things that set off your anger) you can learn to avoid them or cope with them better. IIH Professional taught Quebin that there are some things that make us angry all the the time, "anger buttons" or "triggers".

IIH Professional provided Quebin with a list and asked him to check off all the things that almost always makes him angry such as -being teased -someone telling you what to do -certain noises -being looked at in a certain way -not getting what you want -unfair rules -certain school work -etc.

IIH Professional then helped Quebin brainstorm a list of other things that always turns on her angry buttons (when he loses on a game, when her mother yells at him, when her sister's lie on him and her mother believes them over him).

IIH professional completed Quality Assurance Check list while reviewing Quebin's file in order to review and obtain necessary information to remain in compliance with Medicaid requirements. IIH Professional taught Behavior and Anger Management skills in order to decrease or terminate temper tantrums and replace with controlled, respectful compliance with directions from authority figures.

IIH Professional reviewed activity titled "You Have Anger Buttons". IIH Professional reviewed with Quebin that when you know your anger buttons (the things that set off your anger) you can learn to avoid them or cope with them better.

IIH Professional reviewed with Quebin that there are some things that make us angry all the the time, "anger buttons" or "triggers".

IIH Professional instructed Quebin to complete an additional activity in which he had to write one thing that always turns her anger on and for every on thing that turned her anger on, write on thing that will turn that button off.

Quebin was also instructed to complete and activity in which he had to answer a series of questions in regards to anger buttons such as 1) which anger button can you turn off by simply avoiding a situation?; 2) which anger button represents problems that you have to solve? which problem will you solve first?, etc.

IIH Professional made collateral contact with psychiatric office to obtain email address for on staff medical doctor in order to foster continuity of care between agency and treating psychiatrist. IIH Professional completed authorization for release of information in order to obtain any records from treating psychiatrist office. ----------------------------------------------------------------------------------------------------------------------------------------IIH Professional taught Socialization Skills in order to Imani how to interact appropriately with others as evidenced by her ability to display age appropriate behaviors and interactions.

IIH Professional provided Imani with Feelings Checklist activity in order to help Imani practice paying attention to her feelings. IIH Professional instructed Imani to circle the word or feeling that best describes how often she experiences the certain

feelings, i.e. happy, surprised, sad, worried, frustrated, lonely, included, angry, etc., in addition to a few phrases such as, I asked to join with others, I listened to others, I felt like hurting myself, etc.

IIH Professional prompted Imani to complete "Take Note" section to further asses her emotions and her ability to identify her feelings and how to cope with them on a daily basis.

IIH Professional engaged Imani in a role playing activity to further asses how she handles interactions with peers and authority figures.

IIH Professional made collateral contact with Imani's mother in order to gather information regarding Imani's progress and/or regression in school as well as her behavior at home. ------------------------------------------------------------------------------------------------------------------------------------IIH Professional met with IIH team in an effort to discuss Quebin's Person Centered Plan and discuss progress/regression towards goals in order to assess whether current level of care is appropriate.

IIH Professional taught Quebin Behavior, Anger Management and Social Skills in order to teach him how to implement techniques to physiologically calm herself, how to problem solve without anger or aggression, get along with others, and be able to communicate her needs and wants.

IIH Professional introduced Quebin to Cool Down tools such as drawing and writing. IIH Professional helped Quebin process that hiding difficult feelings thinking that they will eventually go away will allow her feelings to grow and become more upsetting overtime. III Professional further made Quebin aware that telling your mother, peer, sibling, and/or other adult in authority how you feel is always a great idea, but you may be too angry to voice your feelings at that moment. IIH Professional then introduced cool-down tools and instructed Quebin to draw a picture or write about how you feel.

IIH Professional read Quebin a scenario about a boy named Sean who loved to play video games and would get frustrated when he tried to give her brother advice that would make him a better player in order to provide him with a model of behavior that he can relate to.

IIH Professional provided Quebin with a sketchbook since Quebin likes to draw so that he can use it when he becomes upset as a tool that will help him gain control over her anger.

IIH Professional prompted Quebin to think about something that happened that made him angry today and illustrate it in an effort to practice using the cool down tool.

IIH Professional prompted a discussion about the incident that made Quebin angry by having him answer a series of questions provided on a worksheet such as, (Did your feelings change as a result of drawing?, List places where you think you can use ther cool-down tool?, Do you feel comfortable sharing these drawings with anyone?, etc.)

IIH Professional continued to teach Quebin Behavior, Anger Management and Social Skills in order to teach him how to implement techniques to physiologically calm herself, how to problem solve without anger or aggression, get along with others, and be able to communicate her needs and wants.

IIH Professional continued to help Quebin Process the Cool Down tools such as drawing and writing. IIH Professional helped Quebin process that thinking about things that make you happy can also help you when you are upset. III Professional further made Quebin aware that by thinking about the things that make you happy can change your negative thoughts to positive thoughts.

IIH Professional read Quebin a scenario about a boy named Kareem who was having a bad day and remembered to think about positive thoughts that included things he liked and looked forward to and made a collage which included those things he liked to do in order to provide him with a model of behavior that he can relate to.

IIH professional engaged Quebin in an activity of "Things That Make Me Happy", which instructed him to list some of the things that make him happy. IIH Professional helped Quebin to brainstorm her list by asking him about her likes, and favorite pastimes or hobbies.

IIH Professional and Quebin worked on a strategy that would include more than one cool down method in case a situation called for one method over another such as not having paper handy to draw or write.

Mental Health Professional reviewed Quebin's file to ensure file maintenance regarding documentation of CFTs, progress notes, client family involvement sheets, as well as any related documentation such as school reports on academics and behavior. ----------------------------------------------------------------------------------------------------------------------------------------

IIH professional taught Quebin Behavioral and Anger Management Skills in order to further provide him with techniques to physiologically calm yourself, how to think in calm ways, as well as how to implement problem solving w/o anger and aggression.

IIH professional provided Quebin with an Intervention/Activity entitled Managing Difficult Feelings to help him learn to express anger through appropriate verbalizations and healthy outlets.

IIH Professional helped Quebin to process that anger is not the only difficult feeling that people may have. IIH Professional introduced Quebin to other difficult feelings that others may experience such as (jealousy, greed, worry, grief, envy, disgust, disgust, and fear. IIH professional helped Quebin to brainstorm other feelings that maybe unpleasant to him and asked him to write them down so that he can refer back to them at a later date.

IIH professional shared with Quebin situations that will almost always bring up strong and difficult feelings such as a hard test, a visit to the hospital to see a loved one, someone calling you names, and seeing a dead animal in the road. IIH professional helped Quebin to brainstorm other situations that bring up strong and difficult feelings in him.

IIH Professional prompted Quebin to create several faces and give each one a feeling associated with the face ranging from 1 to 7; respectively ranging from very upset to confident. IIH Professional helped Quebin to draw and cut out the faces for ther intervention activity.

----------------------------------------------------------------------------------------------------------------------------------------IIH professional taught Quebin Behavioral and Anger Management Skills in order to further provide him with techniques to physiologically calm yourself, how to think in calm ways, as well as how to implement problem solving w/o anger and aggression.

IIH Professional continued to engage Quebin in intervention/activity in order in which he created several faces and give each one a feeling associated with the face ranging from 1 to 7; respectively ranging from very upset to confident. IIH Professional continued to assist Quebin as he drew and cut out the faces for ther intervention activity.

IIH professional discussed the emotions that the faces represented such as Very upset, upset, worried, unsure, relaxed, calm, and confident. IIH professional modeled the different emotions for Quebin to provide him with a visual of what each one looked like to help him complete activity.

IIH professional taught Quebin 12 ways to control her difficult emotions such as anger, anxiety, fears, and depression (1. take five deep breaths, exhaling slowly; 2. relax body from neck to toe; 3. close your eyes and pretend your in a peaceful place using all your senses; 4. listen to quiet, relaxing music; 5. stretch body out like a cat waking from a nap; 6. slowly draw circles with a common center as you breathe deeply; 7. say, "I can do ther" to yourself ten times, feeling more calmer and confident each time; 8. read an article or book about someone that inspires you; 9. talk a long walk; 10. look at something beautiful for at least five min; chew sugarless gum, it produces calming chemicals to the brain; 11. think about, and be grateful for all the wonderful things in your life.

IIH professional instructed Quebin how to use the Control Your Feelings Scale by demonstrating each step. First, point to the face that best describes your feeling. Next, try on of the above techniques for at least five minutes. Afterward point to the face that best describes your feelings, increasing your score.

IIH Professional guided Quebin on a therapeutic walk in an effort to provide comfortable environment for Quebin which could be utilized as a calming tool.

CST Professional researched interventions regarding Coping and Self Management skills in order to help Yashica cope with her children's behavioral problems with activities that involve learning how to communicate effectively with teens, learning how to implement behavioral tools that will decrease inappropriate behaviors in an effort to decrease the amount of stress by providing coping tools that will help Yashica and her family combat daily issues. IIH Professional researched interventions and activities regarding Communication skills to help DaQujuan and her family communicate appropriately at home and in the community.

IIH Professional made collateral contact with team in order to discuss her current level of functioning and review intervention/activities that have been implemented and assess her progress or lack thereof.

IIH professional taught DaQujuan and her sister Communication Skills in order to address relationships within the nuclear family by increasing positive interactions, positive communication, and resolving conflicts appropriately.

IIH Professional provided intervention/activity regarding Taking Responsibility to help DaQujuan and her sister in gaining clarity about their needs and feelings subsequently improving their communication skills with adults and peers thereby improving the quality of their relationships with others.

IIH professional taught DaQujuan and her sister how to use I messages to teach them how to ensure that people understand a problem from their point of view. IIH professional assisted DaQujuan and her sister process that I-messages is a very specific way of communicating your feelings by having them complete sentences with I-messages by filling in the blanks.

IIH Professional further helped DaQujuan and her sister process I-messages by reading aloud I-messages from other kids. IIH professional prompted DaQujuan and her sister to practice filling in I-messages for different people in their life such as mom, dad, friend, teacher, and brother or sister.

IIH Professional reinforced communication skills by prompting DaQujuan and her sister to answer the following questions in order to further assess their level of functioning: 1) What do you think it is hard for people to talk about their feelings?; What is something you need from your friend that you don't get often enough?; What is something you need from your parents that you don't get often enough?; Who is someone in your life, besides you, who would benefit from using Imessages? IIH Professional instructed DaQujuan and her sister to write down their responses and discuss their answers. IIH professional taught DaQujuan and her sister Communication Skills in order to address relationships within the nuclear family by increasing positive interactions, positive communication, and resolving conflicts appropriately.

IIH Professional taught DaQujuan and her family strategies for holding family meetings. IIH professional helped DaQujuan and her family to process some of the problems that many families face such as a lot of yelling and arguing between brothers and sisters, parents, and between children and parents. IIH Professional discussed how upset children may get when their parents argue and the importance of telling your parents how it makes you feel using I-messages. I feel...

IIH Professional shared with DaQujuan and her family reasons for having a family meeting such as 1) to think about ways they can get along better; 2) to make up a schedule; 3) plan a vacation; and 4) to divide up chores.

IIH Professional helped DaQujuan and her family create an agenda for family meetings in order to ensure that important things are not forgotten when meeting. First, IIH Professional prompted the family to brainstorm an important problem that they would want to discuss. Next, IIH professional had DaQujuan and her family write down two or three things that they think their family needs to plan such as a birthday celebration or trip. Finally, IIH Professional instructed the family to write down three questions each family member could answer to help them share their thoughts and feelings such as "What was the best thing that happened to you ther week?"

IIH Professional made collateral contact with DaQujuan mother to gather information in regards to her recent behavior in school and at home. IIH Professional taught Coping and Self Management Skills in order to address behaviors of aggression that are being displayed at home and at school and address

relationships within the nuclear family by increasing positive interactions, positive communication, and resolving conflicts appropriately.

IIH Professional taught DaQujuan how to become a good problem solver so that he will not feel so angry. IIH Professional provided and discussed with DaQujuan the following steps to teach him how to problem solve: 1. Think of several different solutions to the problem that is causing you difficulty; 2. Consider the pros and cons (pluses and minuses) of each solution; 3. Try the solution that has the most pros; 4. If it doesn't work as well as you thought it would, try to change it to make it work better, or try another solution. Keep trying until you have a good solution. IIH professional prompted DaQujuan to creatively write the steps down on large drawing paper so that he can refer back to them on a daily basis.

IIH Professional helped DaQujuan to process that good problem solving takes practice and that the most important thing you can do differently is to change your attitude about the problems you face by providing him with situations and helping him brainstorm three solutions to each problem. IIH Professional instructed DaQujuan to go back and circle the one that was most likely to work best. IIH Professional and DaQujuan discussed each answer and processed why it was the best choice.

IIH professional engaged DaQujuan in a therapeutic walk in order to model how a physical activity can be used as a coping mechanism to decrease anger.

IIH Professional researched additional intervention/activities regarding coping and self management skills that will assist DaQujuan with meeting the goals set forth in her PCP.

IIH Professional made collateral contact with IIH Team in order to establish contact with ther consumer. IIH Professional coordinated with IIH Team to schedule date and time to meet with Gekierra for the purpose of making initial contact and establishing rapport. IIH Professional reviewed Gekierra's person centered plan and clinical assessment in an effort to familiarize self with precipitating events and diagnosis and current behaviors and level of functioning. IIH Professional inquired as to Gekierra's current schedule, academic hertory and progress. IIH Professional confirmed with Team current contact information such as

step-father's telephone number and current physical address. IIH Professional reviewed service notes to gain information regarding progress and/or lack of progress in regards to current and past interventions used in sessions. Inability to connect and contact consumer as well as conflicting schedules with Team members has slowed introduction with Gekkierra. IIH Professional tentatively scheduled to make contact with consumer next Friday, April 15th. In order to preserve already established rapport with Gekierra and her family introduction has been planned to take place in conjunction with additional IIH Professional.

IIH Professional researched interventions regarding Gekierras diagnosis of Major Depressive Disorder and identified behaviors that led to her family to seek mental health services. IIH Professional also researched interventions and community and private support groups for teenage females that are growing up with parents involved with substance abuse. IIH Professional also researched intervention/activities that will promote positive self-esteem for young women experiencing problems with poor body image. IIH Professional attempted to make contact with Gekierras step-father in an effort to schedule an appointment with Gekierra in home setting. IIH Professional researched summer programs for female teenage youth that incorporated physical activity in order to help Gekierra increase physical activity which may increase level of energy and promote weight loss. IIH Professional made collateral contact with team lead to discuss possibly coordinating initial face to face meeting with Gekierra ther week as opposed to next week. Community programs for teenagers learning how to cope with parents that are experiencing substance abuse issues in the Durham area are limited, but available. Barriers for Gekierra are lack of transportation, lack of family support, and lack of motivation due to living environment and diagnosis. IIH Professional will work with Gekierra in seeking additional support within the community that will help her to cope with current issues regarding low self esteem, poor social skills, and inability to cope which leads to mood swings. IIH Professional made collateral contact with team members to discuss Emonis diagnosis, behaviors , and precipitating events that led to parent seeking and establishing services. IIH Professional reviewed Emonis Clinical Assessment, as well as Person Centered Plan including ITR in order to gather pertinent information needed for rapport building and establishing and creating person centered activities related to behavioral interventions that will assist Emoni in progressing toward the goals set forth in her PCP. IIH professional also reviewed previous service notes to assess the effectiveness of intervention/activities that are presently being used or have been used in the past. IIH Professional further discussed effectiveness of intervention/activities as well as other services being provided such as Outpatient Therapy and the coordination of community services which may help Emoni to build

Emonis self esteem and establish boundaries. IIH Professional further discussed Emonis academic/and behavioral problems in school as well as any school supports that are currently on Emonis Child and Family Team. IIH Professional discussed setting up a meeting with Emoni and her mother in order to provide smooth transition to case by having IIH Team introduce IIH professional to family. IIH Professional gathered information regarding Emoni's level of functioning in school regarding her behavior and academics. IIH Professional coordinated CFT to take place at school in conjunction with other case managing IIH professional. IIH Professional continued to review PCP and Clinical Assessment for pertinent information needed to establish rapport with family such as any background information regarding life domains, diagnosis, and behaviors. IIH Professional reviewed prior progress notes in order to gather information in regards to previous intervention activities used in the past and the effectiveness of those intervention activities in order to gather new intervention activities or review with Emoni some of the previous activities that elicited minor to moderate progress. IIH Professional made collateral contact with IIH Team to discuss recently recommended interventions and programs that Emoni and her mother can be referred to based on Emoni's need for special services related to academic achievement and her diagnosis. IIH Professional researched summer options for Emoni to compensate for drop in academics. III Professional also researched free educational programs offered by Durham Housing Authority, Durham Public Library and 21st Century Programs to link mom to additional resources. IIH Professional researched interventions that will help to motivate Emoni's mother to be more involved with Emoni's academic performance such as the creation of a schedule that will accommodate her interacting with Emoni after school as well as positive reinforcements which Emoni according to her teacher has been known to respond really well to. IIH Professional made collateral contact with Emoni's mother in an effort to establish rapport and gather information regarding Emoni's behaviors and events, circumstances and possible interactions with others that may trigger inappropriate behavior. IIH Professional provided Emoni's mother with background information regarding IIH Professional's professional hertory in field and the different behavioral skills that IIH Professional will work on with Emoni such as social skills, interpersonal skills, behavior and anger management skills, as well as coping and self

management skills. IIH Professional encouraged Emoni's mother to take an active part in Emoni's academic success. IIH Professional assured Emoni's mother that she would teach, and help establish and implement organization skills that will help Emoni to be successful in school regarding academics and behavior. IIH Professional met with Emoni for the purpose of establishing a rapport and to assess Emoni's current level of functioning. IIH Professional encouraged Emoni to share with IIH Professional her likes and dislikes, feelings regarding homework and school, and interest in activities in the community. IIH Professional tentatively discussed a weekly schedule with Emoni's mother regarding face to face visits in the home and community.

IIH Professional made collateral contact with IIH team in order to discuss any progress/regression regarding Patricia's behavior in order to asses the effectiveness of the intervention/activities being used by the IIH Team. IIH Team also discussed the scheduling of Patricia's CFT, advocating for continued IEP interventions to be established in the school setting, as well as the upcoming decision and advocacy for Patricia to receive disability benefits. IIH Team also discussed the transitioning of IIH Professional from team in order to reestablish previous IIH Professional on team. IIH Team made collateral contact with Patricia's mother to inform her of the transition of IIH Professionals. IIH Professional scheduled final visit with Patricia and researched interventions regarding anger management and coping skills in order to teach Patricia how to interact with peers in stressful situations to appropriate resolve conflicts. IIH Team continues to work to ensure that Patricia is provided with comprehensive care in order to help her and her family reach the goals that they set forth in her PCP. Patricia is making moderate progress, with no recent reports of inappropriate behavior from Patricia's school or mother. Patricia's mother's request for disability benefits on Patricia's behalf is still pending. IIH Professional will meet with Patricia for a final session. IIH Professional researched Anger Management Skills in order to provide Patricia with some strategies for resolving conflicts with peers. Patricia reported that she got into a conflict with a peer in her class because the peer pushed her and she and the peer went back and forth until the situation deescalated. Ther interaction was not witnessed by a teacher so there were no consequences for her behavior.

IIH Professional made collateral contact with an administrator at Jaleah's school regarding an incident that occurred in which Jaleah was reprimanded by a teacher for falling asleep in class.

IIH Professional further discussed the incident with the administrator regarding Jaleah's inappropriate behavior and inability to cope with the incident at hand which led to a two-day suspension. IIH Professional coordinated with the administrator to pick Jaleah up early from school in order to begin her suspension that day. IIH Professional obtained Behavioral report which provided details regarding the suspension and the dates for which the suspension take place. IIH professional helped Jaleah to process the incident and her behavior in response to the initial incident that occurred with her teacher. IIH professional reviewed with Jaleah Behavior and Anger Management Skills in order to appropriately verbalize feelings of anger or frustration and learn to control yelling and inappropriate communication. IIH Professional reviewed skill set for alternatives to aggression by using self control such as 1) Tune into what is going on in your body that helps you know that you are about to lose control of yourself (are you getting tense, angry, hot, fidgety-pay attention to internal cues; 2) Decide what happened to make you feel that way (consider outside events or internal events (thoughts)-did someone say or do something to make you mad/upset or did a past event trigger you to become mad/upset; 3) Think about ways in which you might control yourself (slow down; count to 10; assert yourself; leave; do something else-think of an activity that will help you calm down before you lose control; 4) Choose the best way to control yourself and do it- engage yourself in the activity. IIH Professional prompted Jaleah to practice these skills by role playing scenarios that might cause her to become angry or upset such as 1) being criticized harshly by the teacher you might yell at him/her or become disrespectful, instead walk away or remain silent and tell a parent or another teacher how you feel about what took place; 2) being yelled at by your grandmother to clean your room or another room in the house when were not the one to mess it up, instead of reacting disrespectfully or becoming aggressive with her retreat to your room to clean it or engage in an activity such as your favorite game or pastime and when you both calm down talk to her about how you feel when she yells at you; 3) your friend takes something of yours without asking permission, instead of acting on your anger and fighting your friend, you restrain yourself from becoming aggressive and when youre calm you discuss the incident and your feelings regarding your friend betraying you. IIH Professional further helped Jaleah to process her inappropriate behavior by teacher her skill alternatives to aggression by negotiating such as 1) Decide if you and the other person are having a difference of opinion-are you getting tense, or arguing with the other person; 2) Tell the other person what you think about the problem-state your position and your perception of the their position; 3) Ask the the person what he/she thinks about the problem-allow them to state their position and their perception of your position; 4) Listen openly to her/her answer-do not interrupt them while they are stating their position and wait till they are finished to respond if necessary; 5) Think about why the person might feel ther way-are they feeling that way because of something internal or did you do something to make them feel that way; 6) Suggest a compromise-make sure the proposed compromise takes into account the opinions and feelings of both persons, and vice versa if the other person suggests a compromise.

IIH professional directed Jaleah to research the words negotiate and compromise and had journal about past times when she felt she negotiated with someone to come to a solution or compromise on a situation in order to remedy a problem.
Jaleah's school administrator contacted IIH Professional regarding an incident that began with Jaleah being reprimanded by her teacher for falling asleep in class and sent to the main office when Jaleah became argumentative with the teacher. The administrator reported that Jaleah was stopped in the hallway and asked to stop by an another administrator because Jaleah looked upset. Jaleah refused the directive and continue to walk past the administrator who then radioed for assistance. Jaleah was then approached by the reporting administrator and asked to stop but refused. The administrator a

IIH Professional made collateral contact with IIH Team and therapeutic foster care mother in order to coordinate Jaleahs activities over the period of her two day suspension. IIH Professional also made collateral contact with Jaleahs therapist in order to reschedule Jaleahs OPT appointment for a different time, date and location. professional attended Jaleahs CFT which included level II case manager, therapeutic foster care mother, school administration, and LME representative. IIH professional IIH along with Child Family team discussed in meeting the following topics: -recent suspension -appeal of suspension -introduction of new foster care parent/placement -progress made in placement and school despite suspension -request for school behavioral plan -status of PRTF application -PRTFs endorsed by LME/good match for Jaleah -need for monthly visitation plan with grandmother/guardian IIH professional discussed and created letter appealing two-day suspension that Jaleah received in order to lift suspension in which two-days will become excused absences. Team was able to coordinate activities for Jaleah during her two day suspension. Jaleahs OPT appointment was rescheduled in order to accommodate changes in professionals schedules for ther week. CFT resulted in team opting to appeal Jaleahs recent suspension because as per nurse in Wellness Center Jaleah handled the situation very well because she was following plan that was established with Wellness Center in school which provides Jaleah with opportunity and ability to go to the Wellness Center before she engages

in any inappropriate behavior. Team will also complete and submit paperwork in order for a behavioral plan to be established with school and be implemented to inform Jaleahs teachers about her diagnosis, medication and side effects, as well as interventions that should be implemented before a crisis ensues, such as how to approach Jaleah when she is falling asleep in class and when she is angry. Such a plan may diminish the number of negative interactions with teachers and the number of suspensions because it will teach faculty how to interact with Jaleah. IIH professional made collateral contact with Jaleahs therapist and discussed Jaleahs recent suspension, also discussed was Teams appeal of the suspension and request for Jaleah to have a behavioral plan in school in which will inform her teachers of Jaleahs diagnosis and provide them with interventions that will assist in less class disruptions and increased appropriate interactions. IIH Professional discussed Jaleahs grandmother not attending CFT and Teams plans to discuss a mandatory visitation schedule with her that needs to implemented in order for services to continue. Jaleahs therapist is in agreement with the request that the Team is presenting to the school. Jaleahs therapist reported that Jaleah expressed concern for her grandmother because she has not spoken to her in a few days. Jaleah used the IIH Professionals phone to call her grandmother but did not get an answer. Jaleah seemed upset when she could not reach her grandmother. Jaleah was responsive to the intervention/activity and truly wants to make changes. Jaleah has made some changes in her behavior and continues to show improvement daily. Jaleah needed help processing some strategies but was open to IIH professionals explanations. IIH Professional taught Torian Behavior and Anger Management skills in order to decrease or terminate temper tantrums and replace with controlled, respectful compliance with directions from authority figures. IIH Professional provided activity titled "You Have Anger Buttons". IIH Professional taught Torian that when you know your anger buttons (the things that set off your anger) you can learn to avoid them or cope with them better. IIH Professional taught Torian that there are some things that make us angry all the the time, "anger buttons" or "triggers". IIH Professional provided Torian with a list and asked him to check off all the things that almost always makes him angry such as: -being teased -someone telling you what to do -certain noises -being looked at in a certain way -not getting what you want -unfair rules -certain school work -etc. IIH Professional then helped Torian brainstorm a list of other things that always turns on his angry buttons (when he loses on a game, when his mother yells at him, when his sister lies on him and his mother believes her over him). IIH Professional helped Torian create a chart listing the things that always turns his angry buttons

on so that he could keep it on the wall in his room and add to the list when he identifies something new that might turn on his angry buttons. IIH professional reviewed Torian's file for necessary documents in order to review and obtain necessary information to remain in compliance with Medicaid and Service Definition requirements.

Torian was open to the intervention session and was able to identify the things that made him angry. Torian was very vocal when telling IIH Professional the things that his peers did at school that made him angry. There were a lot of things Torian reported that his sister did to him that made him angry. Torian stated that he doesn't like it when he becomes angry and wants to stop being angry all of the time. Mom reported that Torian's sister continues to antagonize Torian and she wants him to learn how to cope with his sister's teasing because it is difficult to get his sister to stop teasing him on a daily basis. IIH Professional will continue to provide Torian with strategies on how to cope with his sister.

Weslee's mother reported that Weslee may not be able to attend the Tarhill Challenged Program due to failure to meet the age requirement by start date. Weslee's mother reported that program rep stated that they will see if a consideration can be made for Weslee since he will meet the age requirement two days after the program is set to begin.

IIH Professional reviewed Weslee's PCP in order to revise the goals that were created initially to meet the standards of internal clinical team. IIH professional revised and discontinued previous goals as well as created new goals that met Weslee and his families needs in regards to him making progress towards consumer and family desired goals and behaviors. IIH professional updated Weslee's ITR to reflect continued behaviors as reported by him and his mother as well as behaviors assessed by the IIH Team. IIH Professional made collateral contact with licensed therapist in regards to conducting Weslee's updated Clinical Assessment that she has been attempting to schedule with Weslee and his mother. IIH Professional and licensed therapist discussed IIH Professional securing a new time and date with Weslee and his mother for the Clinical Assessment to take place. IIH professional contacted Weslee's mother to discuss Weslee's need for an updated CA and to reschedule a new date and time for the CA to take place, Weslee's upcoming re-authorization, and need for a team to schedule a CFT to discuss goals, progress, and introduce new team lead.

Weslee's mother has not been returning phone calls to IIH Team in regards to rescheduling an updated Clinical Assessment, and scheduling a CFT. Weslee's mother reports that she has been busy and that she would contact the IIH Team when she has a free moment to schedule the previous stated important events. IIH Team will continue to make contact with Weslee's mother to obtain signature on updated PCP and to go over revised goals as well as settling scheduling issues.

IIH Professional taught Enrico Coping and Self Management Skills in order to improve coping skills in order to decrease defiance towards adults and manage anger outburst. IIH Professional taught Enrico techniques for effective emotional management by helping him to develop skills in communication, problem solving and relaxation. IIH Professional had Enrico process the following steps by writing them down to help retain information and so he could refer back to the following skills during times of extreme stress: 1)Talking It Out-use tools to express yourself appropriately through the use of "I Messages", identifying feelings, scaling to be able to discuss the intensity of your feelings. IIH Professional had Enrico identify several people that he feels comfortable discussing problems with so that he can be able to validate his feelings with attention and time from a valued adult; 2)BrainstormingIIH Professional and Enrico brainstormed a list of possible solutions to past and present situations;3)Stress Relievers-IIH Professional and Enrico brainstormed ways for Enrico to relax that fit his personality and interest such as hanging out with his friends, spending quality time with his grandmother, spending time with his dad and compared them to a list of stress relievers that he may practice that are not as positive as those examples such as fighting, hanging out with the wrong crowd, and smoking cigarettes. IIH Professional reviewed with Enrico relaxation skills that he can use when feeling frustrated, angry, or overwhelmed such as engaging in his favorite pastime, engaging in a sports activity, taking deep breaths to physically calm himself, IIH Professional demonstrated some of her own coping skills and discussed when she implements them to provide Enrico with an idea of he can learn how to implement his own. IIH Professional also reviewed unhealthy coping strategies such as explosive or angry behavior, self-mutilation, drugs, alcohol, and tobacco use, school avoidance. IIH Professional and Enrico reviewed the benefits of relaxation: 1) once learned are versatile because they can be used anytime, anywhere, and for practically any situation; 2) they don't require any special equipment and can be modified for the individual user; 3) empower teens to feel that they have some control over their emotions; 4) simple enough to teach that teens can easily share them with others. IIH Professional helped Enrico to brainstorm the benefits of the relaxation strategies that he would like to implement, 1) engaging in a sports activity helps him to hone his skills at a sport that he enjoys as well as relax, 2) his relaxation strategies don't cost him anything, and he gets to enjoy time with people that he loves. IIH Professional taught Enrico 3 basic types of relaxation techniques such as 1. Progressive Muscle Relaxation-Focus on one muscle at a time, alternately contracting and relaxing the

muscle; 2.Guided Imagery-choose a relaxing scene at the focal point; location teen finds personally meaningful and calming. Utilization of all five senses; 3.Controlled Breathing-slow purposeful breathing that helps increase calmness and relaxation; breathe in through nose for 3-4 seconds and out the mouth for 6-8 seconds for a period of 5 to 10 minutes. IIH Professional demonstrated each technique for Enrico and had him model each technique to ensure Enrico understood how to implement each technique on his own. IIH Professional made collateral contact with Enrico's grandmother in order to schedule his Client Family Team Meeting. IIH Professional provided Enrico grandmother with some meeting points that would be discussed in the meeting scheduled for Thursday, July 21st.
Enrico seemed reserved when IIH professional initially arrived to engage Enrico in IIH activity. Enrico seemed to loosen up when IIH Professional engaged him in some small talk about his weekend. Enrico was able to fully engage himself in the activity which was evident by his ability to focus on each task at hand without having to be redirected. Enrico stated, "hanging out with my grandma", was his favorite way to spend his time. IIH Professional facilitated Client Family Team meeting which included Enrico, Enrico's grandmother, his grandmother's male companion, and entire IIH team in order to discuss and review past behaviors to assess progress or lack thereof, new issues of concern, safety concerns, interventions, as well as Enrico and his family strengths. IIH Professional made introductions between Enrico and his family and new IIH Team lead. IIH Professional prompted Enrico and his family to discuss any concern and/or issues that they felt needed to be addressed by IIH Team. IIH Professional encouraged Enrico to open up and reveal feelings concerning the issues that his family felt needed to be addressed. IIH Professional documented all information received and discussed in the CFT meeting. The following issues were discussed: -Enrico smoking cigarettes (Enrico reported that he quit) -Enrico display of immature behavior -Enrico's refusal to complete task set by his grandmother -Enrico engaging in unsafe behaviors such as setting fire to things in the home such as pencils and other objects in the home, and meeting neighbors on the room of his home which may also lead to home invasions. -Enrico's feelings of abandonment in regards to his biological parents. Enrico's inability to manage his anger -Enrico's grandmother enforcing rules in the home and implementing consequences. -IIH Professional's helping Enrico's grandmother advocate for his education and behavioral modifications in school setting -Enrico and his grandmother's positive relationship. IIH Professional and team discussed CFT meeting and assessed the family dynamic that was displayed in the meeting between Enrico and his grandmother and the role

Enrico's grandmother friend plays in his life. IIH Team assessed Enrico's clingy behavior in regards to his grandmother as well as the immaturity that was displayed by all family members in regards to how they tend to communicate with Enrico.

Enrico was quiet during the CFT and let his grandmother and her companion do a lot of the talking. Enrico displayed age inappropriate behavior as he laid on his grandmother and kept complaining about being tired. However, Enrico and his grandmother displayed a healthy relationship with one another that was affectionate and loving. When his grandmother's companion joined the dynamic some immaturity was amongst the three which included bickering and finger pointing as the grandmother played referee. Enrico's grandmother's companion reported that he was providing Enrico with cigarettes. Enrico reported that he stopped smoking and was not going to smoke again. Enrico's grandmother reported that Enrico wanted to be a "gangster" and she was not going to let her grandson take that route in life. Enrico's grandmother also reported that Enrico is immature and is constantly "messing" with her which due to her heart problems causes her undue stress. Enrico's grandmother companion made the same reports regarding Enrico's behavior and how it takes a toll on his grandmother's health. Enrico's grandmother reported that Enrico engages in risk taking behaviors such as climbing on the roof of their apartment to interact with a neighborhood peer. Enrico barely said a word in regards to his behavior even when prompted. Enrico's grandmother stated that Enrico's father is in his life on a inconsistent basis which upsets Enrico because his father makes promises that he can't keep and Enrico looks forward to spending time with his father. Enrico has a very supportive grandmother that is willing to work at ensuring that Enrico is successful.